@layout("/common/_form.html",{js:["/assets/modular/system/btyAqjj/btyAqjj_edit.js"]}){

<form class="layui-form" id="noticeForm" lay-filter="noticeForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">安全基金修改信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="id" value="${id}" type="hidden"/>
                    <input name="pid" value="${pid}" type="hidden"/>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">店名</label>
                        <div class="layui-input-block">
                            <input name="dm" value="${dm}" onfocus="this.blur()" type="text" class="layui-input"/>
                        </div>
                    </div>

                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">营业执照法人</label>
                        <div class="layui-input-block">
                            <input name="yyzzfr" value="${yyzzfr}" type="text" class="layui-input"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6" style="height: 30px">
                        <label class="layui-form-label label-title">食品经营许可</label>
                        <div class="layui-input-block label-block">
                            <input name="spjyxk" class="layui-input" type="text" autocomplete="off"
                                   value="${spjyxk}" placeholder="食品经营许可" id="spjyxk"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">是否购买意外险</label>
                        <div class="layui-input-block">
                            <input name="ctywxgm" value="${ctywxgm}" placeholder="是/否" type="text" class="layui-input"
                                   id="ctywxgm"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6" style="height: 30px">
                        <label class="layui-form-label label-title">意外险截止时间</label>
                        <div class="layui-input-block label-block">
                            <input name="ctywxjzsj" class="layui-input" type="text" autocomplete="off"
                                   value="${ctywxjzsj}" placeholder="餐厅意外险截止时间" id="ctywxjzsj"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6">
                        <label class="layui-form-label">是否购买公共责任险</label>
                        <div class="layui-input-block">
                            <input name="ctggzrxgm" value="${ctggzrxgm}" placeholder="是/否" type="text"
                                   class="layui-input"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md6" style="height: 50px">
                        <label class="layui-form-label label-title">公共责任险截止时间</label>
                        <div class="layui-input-block label-block">
                            <input name="ctggzrxjzsj" value="${ctggzrxjzsj}" class="layui-input" type="text"
                                   autocomplete="off"
                                   placeholder="餐厅公共责任险截止时间" id="ctggzrxjzsj"/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" ew-event="closeDialog">&emsp;取消&emsp;</button>
    </div>
</form>

@}